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How will I know when I'm in labour?
Every woman's labour is different. So pinpointing when yours begins isn't really possible. It's more of a process than a single event, when a number of changes in your body work together to help you to give birth.
However, some specific changes take place in pre-labour, early labour and established (active) labour. Your midwives are most likely to focus on established labour. This is when your cervix dilates from 3cm (1.2in) to 4cm (1.6in) onwards.
In pre-labour or early labour (the latent phase), you may have:
- Persistent lower back pain or abdominal pain, with a pre-menstrual feeling and cramps.
- Painful contractions that occur at regular and increasingly shorter intervals, and become longer and stronger in intensity.
- Broken waters. Your membranes may rupture with a gush or a trickle of amniotic fluid. Either way, call your maternity unit to let them know.
- A brownish or blood-tinged mucus discharge (bloody show). If you pass the mucus plug that blocks the cervix, labour could be imminent, or it could be several days away. It's a sign that things are moving along.
- An upset tummy or loose bowels.
- A period of feeling very emotional or moody.
- Disrupted sleep.
How you will feel in the pre-labour or early labour phases depends on:
- Whether you've had a baby before.
- How you perceive and respond to pain.
- How prepared you are for what going into labour may be like.
When should I call my midwife?
You have probably talked to your midwife about what to do when you think you're in active labour. But if you're not sure whether or not the time has come, don't be embarrassed to call. Midwives are used to getting calls from women who are uncertain if they're in early labour or active labour, and who need guidance. It's part of their job.
A midwife can tell a lot by the tone of your voice, so talking helps. She'll want to know how close together your contractions are, whether you can talk through a contraction, and any other symptoms you may have.
If you're planning to have your baby in hospital or in a birth centre, she may ask you to come in so she can make an assessment.
If she thinks you're still in early labour, she is likely to encourage you to go home until you're in stronger active labour. Her decision will depend on how you're coping and whether you've got a birth partner to support you.
You should contact your midwife or doctor if:
- Your waters break, or if you suspect you're leaking amniotic fluid.
- Your baby is moving less than usual.
- You have vaginal bleeding (unless it's just a small amount after a membrane sweep or the blood-tinged mucus of the show).
- You have a fever, severe headaches, changes in your vision, along with abdominal pain.
What should I do early on in labour?
This will depend on what time of day it is, what you like doing, and how you're feeling. Keeping calm and relaxed will help your body to release the hormone oxytocin that you need for your labour to progress and will help you to cope with the contractions. Do whatever will help you to stay relaxed.
This could mean watching your favourite film, going for a walk, pottering around at home, or asking a trusted friend or relative over to keep you company. You could alternate between walking and resting, or try taking a warm bath or shower to ease any aches and pains. If you can, try to get some rest to prepare you for the work ahead.
During early labour, you may feel hungry, so eat and drink if you feel like it. This will help to comfort you and may even help your labour to progress more smoothly.
Early labour is a good time to try out different positions, breathing techniques and visualisations to see if they help you to cope with the contractions. If you've got a TENS machine, early labour is the time to use it.
Can I have contractions and not be in labour?
Yes. You can have pre-labour contractions. These help your cervix to go through the changes it needs to before it starts to dilate. During dilation, your cervix moves from the back (posterior position) to the front (anterior position). It will also be shortening and thinning (softening and effacing).
These changes may take place without you noticing over the last few weeks of your pregnancy. Or you may experience hours or days of cramps or contractions. These may be progressing the early changes in your cervix, even though they may not be dilating your cervix yet.
A midwife can confirm whether cervical changes have started during an examination. At your 40 week appointment your cervix may be firm and unyielding, while at the next appointment it may be "paper thin" (starting to open).
If your baby has his head down but his back to your back, it can take longer for his head to engage and for labour to start. Your contractions may be erratic and low in intensity, and you may have backache.
Your midwife will advise you about ways to cope at home until labour becomes stronger. You could take a dose of paracetamol or try a warm bath or massage to relieve the pain. If your baby is back-to-back, getting into an all-fours position, on your hands and knees, for half an hour or so now and again can help relieve backache.
Can I tell if labour is about to happen soon?
Maybe. Signs of the approach of labour include:
- Lightening, when your baby's head begins to drop into position in your pelvis. You may be able to breathe more deeply and eat more, but you'll also need to wee more frequently, and walking may be more difficult.
- Heavier and more mucus vaginal discharge.
- More frequent and noticeably more intense Braxton Hicks contractions.
- Mood swings and a surge of energy.
- A sudden urge to clean your home!
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